4123-18-04
Living maintenance allowance.

The bureau shall order living maintenance to be paid from the
surplus fund, established by section
4123.34 of the Revised Code, to
each injured worker in accordance with the guidelines listed below. Living
maintenance payments are compensation under Chapters 4121. and 4123. of the
Revised Code.

An injured worker is eligible for living maintenance payments
in accordance with the guidelines of this rule.

(A)
Living maintenance payments shall begin
on the date that the injured worker actually begins to participate in an
approved vocational rehabilitation assessment plan or
comprehensive vocational rehabilitation plan as defined in rule
4123-18-05 of the Administrative
Code . Living
maintenance is not payable on the date of
referral for vocational rehabilitation services,
nor the date the injured worker signed the rehabilitation agreement. Activities
performed prior to the injured worker's active participation in the approved
vocational rehabilitation assessment plan and/or
comprehensive vocational rehabilitation plan are considered pre-plan
activities for which living maintenance is not paid.

If salary continuation is offered by the employer of record, an
injured worker maintains the right to choose to receive either salary
continuation or living maintenance during vocational rehabilitation. However,
if temporary total or living maintenance has been paid in the claim, the
injured worker shall be paid living maintenance when participating in an
approved vocational rehabilitation assessment plan or
comprehensive vocational rehabilitation plan. Whenever salary
continuation is paid by the employer, it must be paid at the injured worker's
regular (full) salary level.

(B)
The bureau shall order suspension of
living maintenance payments at such time as it becomes evident that the injured
worker will not be able to participate actively in their vocational
rehabilitation assessment plan or comprehensive
vocational rehabilitation plan for a period of thirty days or more due to
the medical instability of the injured worker. The suspension of living
maintenance shall not affect an injured worker's right to compensation or
benefits under the Revised Code for which the injured worker otherwise
qualifies.

(1)
The bureau shall assist the
injured worker in obtaining the payment of other workers' compensation benefits
to which the injured worker would normally be entitled absent involvement in a
vocational rehabilitation assessment plan or
comprehensive vocational rehabilitation plan upon the cessation of living
maintenance payments.

Upon request from the MCO, the bureau shall determine whether,
based on adequate medical documentation, the injured worker's vocational
rehabilitation plan should be closed with a medical hold.

(a)
A medical hold will retain the injured
worker's eligibility for vocational rehabilitation services for up to a maximum
of two years from the date of vocational rehabilitation assessment plan or comprehensive vocational
rehabilitation plan file closure. The bureau and the MCO shall thereafter
monitor the injured worker's medical status with the attending
physician.

The termination of living maintenance shall not affect an
injured worker's right to compensation or benefits under the Revised Code for
which the injured worker otherwise qualifies.

(D)
The bureau may order deduction from any
living maintenance payment an amount equal to:

(1)
One-seventh of the weekly payment to
which an injured worker is entitled for each full day during which the injured
worker fails, without good cause, to participate in their approved vocational
rehabilitation assessment plan or comprehensive
vocational rehabilitation plan.

(2)
Any wages or other remuneration received
by the injured worker while participating in an approved vocational
rehabilitation assessment plan or comprehensive
vocational rehabilitation plan and receiving living maintenance must
either be endorsed over to the bureau, or will be deducted from the injured
worker's living maintenance payments or from future awards of
compensation.

(E)
Living
maintenance payments shall not be ordered by the bureau for a period or periods
exceeding six months in the aggregate, unless the bureau determines that the
injured worker will benefit from an extension of vocational rehabilitation
services.

(F)
Appeals regarding
determination of an injured worker's eligibility for living maintenance
payments shall be filed with the bureau within fourteen days of receipt of the
bureau's determination.